Adherence, Effectiveness, Safety and Predictors of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia: Retrospective Follow up Study.

Adherence, Effectiveness, Safety and Predictors of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia: Retrospective Follow up Study. | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Adherence, Effectiveness, Safety and Predictors of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia: Retrospective Follow up Study. Dagnew Tigabu, Yabibal Asfaw Derso, Tadesse Misganaw, Fikadie Dagnew Baye, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8707598/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background - The World Health Organization recommends integrase inhibitor dolutegravir as the first- and second-line treatment of choice for Human Immunodeficiency Virus in July 2019 for all populations. Since 2019, Ethiopia's Ministry of Health has advised adults, adolescents, and expectant mothers to use it as their initial antiretroviral treatment regimen. There are limited studies demonstrating the adherence, effectiveness, and safety of children and adolescent dolutegravir regimen therapy in Ethiopia. Methods - institutional based retrospective follow up study conducted by involving children and adolescent with dolutegravir regimen therapy at antiretroviral therapy clinic of Amhara Region Specialized Hospitals. Eligible children and adolescents were consecutively recruited at admission and followed up for one ( 1 ) year. The sample size of ART children and adolescents was 403 included in the study. A simple random sampling technique by lottery methods was used. Data were collecting using structured questionnaire from client medical record folder. The data was analysis by using SPSS Version 25 software and evaluate the data with Binary logistic regression Model. Descriptive statistics were computed depending on the nature of the variables. Binary logistic regression Model used to assess predictors. Predictors considered statistically significant if P -value was less than 0.05. Result - In total, 90.1% of participants adhered well to the treatment. At the start, 65.9% of those on DTG were in WHO Clinical Stage III. After follow-up, 67.4% were in Stage I and 32.6% in Stage II. Initially, 97.8% had viral loads above 200 copies/mL, but after one year on DTG, 87.4% were dropped below the threshold. CD4 counts improved significantly: 51.6% began below 200 cells/mm³, but with most now at 350 or higher. Additionally, 33.3% of patients reported adverse drug effects (ADEs) following the DTG regimen. Conclusion - This study indicated that the use of DTG-based ART in children and adolescents is safe with minor ADEs. In addition, the DTG regimen is successful in this population, especially in treatment-experienced children who had high viral load before converting to DTG-based therapy. However, the majority of kids and teenagers adhered well to DTG regimens. adherence effectiveness safety children adolescents antiretroviral therapy dolutegravir Figures Figure 1 Figure 2 Introduction At least two nucleosides (nucleotide reverse transcriptase inhibitors) and a third medicine from any of the following pharmacological classes have constituted the cornerstone of HIV treatment: Protease inhibitors (PIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), and integrase strand transfer inhibitors (INSTIs), such as dolutegravir (DTG) and raltegravir (RAL). HIV infection is now regarded as a chronic illness that may be controlled over time rather than a deadly condition because of the use of antiretroviral medication (ART) ( 1 – 3 ). Dolutegravir (DTG) is a member of the relatively new class of antiretroviral treatment (ART) drugs known as integrase strand transfer inhibitors (INSTIs). The mechanism of action terminates the life cycle of the virus by preventing the integration of HIV nucleic acid into the genome of the host T-lymphocyte. The main uses of raltegravir, the first INSTI to register with the South African Health Products Regulatory Authority (SAHPRA), were in third-line regimens and as salvage therapy for patients who did not react to second-line regimens based on protease inhibitors. Since then, the third drug to be approved for use as first-line therapy is efavirenz (EFV), which is administered in conjunction with two nucleoside/nucleotide reverse transcriptase inhibitors. EFV will basically be replaced by DTG. DTG is associated with better viral suppression, fewer drug-drug interactions, and a decreased chance of drug resistance mutations emerging as compared to EFV ( 4 , 5 ). DTG is a crucial antiretroviral drug that has emerged as the mainstay of many HIV programs, especially those in sub-Saharan Africa. It has recently replaced efavirenz as the third drug that is advised for patients beginning antiretroviral therapy in South Africa. Its cost-effectiveness, tolerability, and favorable resistance profile have affected HIV care worldwide, including the most recent revision to WHO antiretroviral guidelines. However, making educated decisions is essential, just like with any drug. Despite the many advantages of DTG, recent studies have revealed risks that exceed advantages, thus a doctor should carefully balance these before recommending DTG. This essay's goal is to give primary care physicians a summary of the benefits and drawbacks of South Africa's DTG rollout( 4 ). Sub-Saharan Africa continues to be the region most severely impacted by HIV/AIDS, one of the worst public health issues in the world. At the end of 2020, 150,000 children were newly infected, and an estimated 1.8 (1.2–2.2) million children aged 0–14 lived with HIV. An estimated 100,000 youngsters perished from diseases linked to AIDS ( 5 ). As of July 2019, the World Health Organization (WHO) recommended integrase inhibitor DTG as the preferred first- and second-line treatment for HIV in all populations, including those who are or may become pregnant( 5 ). Since then, several low- and middle-income countries have changed their policy to use DTG-based HIV treatment regimens instead of EFV-based first-line ART. DTG is now the recommended drug for patients starting ART for the first time, those experiencing EFV side effects, and those who choose to use DTG, according to a 2020 revision of South Africa's national HIV guidelines. Benefits of new medications in the ART arsenal are anticipated to include reduced costs, fewer tablets consumed, decreased viral load, fewer side effects, and a stronger genetic barrier to resistance ( 4 ). Quick absorption, a once-daily dosage requirement, and the option to take DTG with or without food are all features of its posology. There is no need for pharmacological boosting ( 6 , 7 ). mpaired renal function has no appreciable impact on the pharmacokinetics of DTG because of its low urine excretion ( 8 ). A prescription for DTG (50 mg tablet) or a fixed dose combination of 300 mg of tenofovir disoproxil fumarate (TDF) and 300 mg of lamivudine (3TC) may be given to those who weigh more than 35 kg and are older than 10 years. DTG's efficacy and improved safety profile were demonstrated in numerous clinical trials conducted on both ART-naive and ART-experienced participants ( 9 – 12 ). The FDA recently approved dolutegravir, the most recent INSTI, in a single-tablet regimen (STR) with abacavir and lamivudine( 13 ). You can take dolutegravir once daily. Nowadays, dolutegravir is one of the first antiretroviral regimens that is advised, along with either abacavir-lamivudine or tenofovir-emtricitabine ( 14 , 15 ). Despite the undeniable effectiveness of ART, some problems still exist. Patients will have to take the medications for the rest of their lives since they are unable to fully eradicate the virus, which puts them at risk for harmful side effects, drug interactions, and drug resistance( 16 ). In many low- and middle-income nations overall, this nonadherence may contribute to an increase in pretreatment HIV medication resistance, treatment failure, and resource waste among individuals starting or continuing first-line ART ( 17 ). Ethiopia's Ministry of Health (MOH) has advised adults, adolescents, and expectant mothers to use TDF+3TC + DTG (TLD) as their first-line ART regimen from 2019. Compared to fixed-dose combinations (FDC), TLD is a simpler, less hazardous, more convenient, and more efficient regimen. DTG's efficacy has been demonstrated in numerous randomized controlled trials with individuals who have never used ART before as well as those who have ( 18 ). 64.5% of patients had sustained suppression for six months, and 66.7% of patients had a viral load < 50 copies/ml at the one-year follow-up. The baseline and 6-month viral load counts were substantially correlated with viral suppression at the one-year follow-up. At baseline and at 6-month follow-up, 60.6% and 57.9% of the 38 patients who did not achieve virological suppression after a year, respectively, had viral loads greater than 50 copies/ml. After six and one years of follow-up, the rates of virological failure (viral load > 1000 copies/ml) were 16.2% and 16.5%, respectively ( 19 ). According to self-report, the 200 patients evaluated in a prospective cohort trial in Tanzania had high (48%), moderate (40.5%), and poor (11.5%) adherence rates( 19 ). Patients who were new to ART had a greater self-reported adherence rate (69%) than those who had previously received treatment (44.4%). 71% of individuals were found to be highly adherent to the DTG-based HAART regimens using the drugstore refill. Additionally, ART-naïve individuals (82.8%) showed higher levels of adherence than patients with prior treatment experience (69%). According to the self-reporting assessment, only 51.4% of the 142 patients who had high adherence based on pharmacy refills also had high levels of adherence ( 19 ). The overall cohort's mean CD4 + cell counts at baseline were 595 cells/mm3. Thirteen percent of the patients had CD4 + cell counts below 200 cells/mm3. Additionally, the mean CD4 + cell counts six months after starting DTG-based HAART regimens were 567.5 cells/mm3, with only 6% of patients having a CD4 + count below 200 cells/mm3. After beginning a DTG-based treatment, all patients with CD4 + cell counts below 200 cells/mm3 had low baseline CD4 + cell counts. Between baseline and six months following the DTG-based regimen, the average difference in CD4 + cell counts was 0.63 cells/mm3. Furthermore, overall, 70.2% of individuals had an undetectable viral load six months after starting DTG-based HAART regimens ( 19 ). A retrospective cohort study of Tanzanian children and adolescents found that 91.64% of them had viral suppression. In total, 88.45% of previously suppressed people remained repressed, and 66.19% of previously unsuppressed people were suppressed ( 20 ). Two patients (1 and 2) stopped taking ART during follow-up, necessitating unplanned clinical visits. The viral load peaks for patients 1 and 2 were 1779 and 4100 copies/ml, respectively. At later visits, we saw virologic suppression as a result of better adherence to ART and a quicker reaction to DTG-based ART after talking with both patients about the significance of adherence and the dangers of developing further drug resistance mutations ( 21 ). Overall, 78.8% of patients experienced persistent virological suppression during follow-up, and 88.1% of people had viraemia suppressed at the last visit, per a retrospective follow-up research conducted in France ( 22 ). Although the overall rate of side effects is close to 90%, this optimistic estimate includes mostly minor reactions that mostly go away over time and might not be totally drug-related. Although headache, nausea, and diarrhea are common side effects, only 1% of patients experience severe reactions (grade III or IV) ( 23 ). Additionally, less than 2% of adverse events attributed to dolutegravir resulted in treatment discontinuation, which is similar to raltegravir and lower than efavirenz and PI-based regimens ( 24 ). In individuals with prior treatment experience, there was no change in the overall frequency of adverse events or the frequency of adverse events that resulted in drug cessation when compared to raltegravir ( 25 ). Dolutegravir has not been associated with an increase in cardiovascular risk ( 26 – 28 ). Further proof of the tolerability of dolutegravir is the similar side effect profile observed when given twice daily, even among those with advanced immunosuppression ( 29 , 30 ). Only one patient discontinued therapy due to dolutegravir-related adverse effects (dizziness and sleep problems), indicating that the medication was well tolerated. The three grade 3 laboratory events (acute liver abnormalities that went away without dolutegravir stoppage) were deemed unrelated to the drug. There were no AIDS-related incidents or fatalities ( 22 ). A retrospective cohort study in Tanzania found that children and adolescents aged 10–14 and 5–9 years were 2% less likely to achieve HIV viral suppression than those aged 1–4 years. Participants in WHO Stage I were 1.03 times more likely to be virally suppressed than those in Stage IV. Previously unsuppressed individuals had an 8% lower likelihood of achieving suppression compared to those who were previously suppressed. Those on antiretroviral therapy (ART) for over 24 months were 4% less likely to achieve suppression than those on ART for 24 months or less. Participants with a multi-month subscription were 1.25 times more likely to achieve viral suppression than those without. Additionally, individuals not retained in care were 17% less likely to be virally suppressed, and those with severe nutritional issues were 23% less likely to achieve suppression compared to those without malnutrition. Conversely, participants living in the coastal zone were 2% less likely to achieve viral suppression than those in the western zone ( 20 ). In accordance with the WHO's recommendation, the Ethiopian government has included DTG-based regimens in the 2018 National Comprehensive HIV Prevention, Care, and Treatment Guidelines as part of its ongoing efforts to prevent HIV transmission and enhance the quality of HIV care and treatment services ( 5 ). Tenofovir/Lamivudine/Dolutegravir (TLD) use started in Ethiopia in February 2019 and was first introduced in the research domain (Lumame Primary Hospital) on April 1, 2019.6 However, there are currently no published studies evaluating the appropriate use of ART medications such as the TLD in Ethiopia; therefore, drug use patterns help identify gaps in medication use and implement initiatives that promote responsible drug consumption ( 31 , 32 ). s In Ethiopia, changes are being made to the treatment guidelines based on the evidence regarding treatment Adherence, efficacy and safety. Such changes call for economic evaluations to investigate the cost effectiveness of the newly introduced regimen and to examine whether the added cost of therapy can be justified by the added benefit. However, the new regimen is being implemented without a proper economic evaluation of its costs and outcomes in the Ethiopian context. This study therefore aimed to evaluate the cost effectiveness of replacing an EFV-based regimen with a DTG-based regimen as a preferred first-line treatment for HIV/AIDS patients in the Ethiopian context. Methods and Materials Study Design, area and period An institution-based retrospective follows up study will be conducted in Amhara Regional State Comprehensive Hospitals, at Tibebe Ghion, Felege Hiwot, Gondar, Debre Tabor, Debre Markos, Woldia, Dessie and Debre Birhan specialized hospitals in Amhara Regional State. Currently the state has eight comprehensive specialized hospitals. From the total eight Specialized Hospitals only four Specialized Hospitals are selected for study area by lottery methods. The Four these hospitals (Debre Tabor, Felege Hiwot, Woldia and Dessie) are selected, that serving for more than 5 million people each and organized in different wards; medical ward, surgical ward, gynecology and obstetrics ward, orthopedics ward, oncology ward, pediatric ward, intensive care unit, NICU and different outpatient departments. FHCSH the total currently on DTG regimen are 213. Debre Tabor Comprehensive specialize hospital the total currently on DTG regimen are 153. Dessie Comprehensive specialize hospital the total currently on DTG regimen are 318. Woldia Comprehensive specialize hospital the total currently on DTG regimen are 179. The study conducted in 2025 G. C. Population selection and participation All records of children and adolescent who’s weighing ≥ 20kg and attending in ART clinics with on DTG based regimen therapy of selected public hospitals of Amhara Regional State during the study period were included. Unfortunately, all children and adolescent with incomplete medical records (incomplete Viral load, non-DTG based regimen and adverse effect records), Children and adolescents with co-morbidities like diabetes mellitus, tuberculosis (TB), liver disease, renal disease, and malaria were excluded. Patients taking medicines that are likely to interact with DTG, such as herbal supplements, antacids, and ferrous sulfate, were excluded. Sample size determination, Sampling Technique and Procedure Using Double population proportion formula was used to calculate the sample size by using independent predictors of poor adherence, effectiveness and had adverse drug effect of Dolutegravir based antiretroviral regimens from previous study conducted with 95% CI, a power of 80% and 1:1 ratio of exposed to non-expos ( 20 ). By considering 10% for non-response rate, the total sample size was 403 using Epi-info version 7.2.6 was used to calculate sample size. All HIV infected children and adolescent who attending ART clinic with DGT based regimen therapy from July 01/2014 to June 30/20156 E.C were included in the study. Firstly, All HIV infected children and adolescent who attending ART clinic with DGT based regimen therapy card numbers obtained from ART clinic registration logbook. The overall total number of participants in three hospitals was 863. All participants medical registration number were listed with a sample frame from 1 up to 863. Then proportional allocation of sample taking for each hospital was calculated by using a proportional allocation formula. So that, the sample sizes drawn from Felege Hiwot, Debre Tabor Woldia and Dessie specialized hospitals are 100, 71, 84 and 148, respectively. Finally, the study subjects for each hospital selected by simple random sampling technique using the list as a sampling frame. Data Extraction Tool, Procedure and Quality Control Data Extraction Tool, Procedure and Quality Control The data was collected using a checklist adapted from previous literature ( 19 ). This checklist included: socio-demographic factors, clinical and medication-related factors and family member influences on poor adherence, effectiveness, and drug adverse effects. Two weeks prior to the actual data collection, the checklist was pretested on 5% of the sample size in a location outside the study area with a similar population. Additionally, a two-day training session was provided for data collectors and supervisors, covering the data collection tools and the study's objectives. Trained data collectors gathered the data using the checklist, while supervisors and the principal investigator closely monitored the entire process and reviewed daily submission reports. Study Variables and Their Measurements The outcome variable was Adherence, effectiveness, safety and Predictors of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals and this was measured as adherence, effectiveness and safety of DTG regimen therapy (good/poor, good or poor and had drug adverse effect or not) respectively. Adherence: - Adherence was assessed using self-reporting and pharmacy refill methods by calculated, number of days for the pills dispensed previously- delay in days for next pickup / number days for the pills dispensed previously * 100 in the three months intervals for the period of one year ( 19 ). Good ART adherence -equal to or greater than 95% adherence i.e., missing up to 2 out of 30 doses or up to 4 from the 60 doses implies good adherence ( 1 ). Poor ART adherence -less than 95% adherence, i.e., missing > 5 doses out of 30 doses or > 10 doses from 60 doses implies poor adherence ( 1 ). Effectiveness: - The CD4 + cell counts and viral load data were obtained from the patient’s laboratory data. The viral load was measured using the Abbott Real-Time HIV-1 (Abbott Molecular Diagnostics, Wiesbaden, Germany) with a minimum detection level of < 50 copies/ml. These data were collected at baseline, 6 months, and 1 year after initiating the DTG-based HAART regimen ( 19 ). Good :- the result of the laboratory finding of viral load was 2 WHO stage and had ≤ 200 of CD4 count ( 19 ). Safety: - is monitored based on the incidence and severity of adverse drug events (ADEs) and toxicity based on the abnormal range of laboratory tests and spontaneous reporting ( 19 ). Follow-up time: - at the time enrolled in the DTG-based regimen, up to 1 year. Data Processing and Analysis Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 25. Before conducting the study, continuous variables were log-transformed to meet statistical assumptions. Descriptive statistics were used to summarize both clinical and laboratory results. Continuous variables were expressed as mean ± standard deviation (± SD), while frequencies and percentages represented categorical variables. The primary outcome of the study was the percentage of patients who adhered to at least 95% of the DTG-based antiretroviral therapy (ART) regimen within one year. Secondary outcomes included the percentage of patients who maintained a viral load of less than 50 copies/ml after one year. Safety outcomes involved the percentage of patients who reported adverse drug events (ADEs) while on DTG-based highly active antiretroviral therapy (HAART) regimens, as well as those who had laboratory results outside the normal range. To identify predictors of achieving poor adherence (< 95%) of using the drug, the participants had effective outcomes based on a DTG-based regimen, and also had no drug adverse effects within one year. A binary logistic regression model was utilized. Results were considered statistically significant if the p-value was less than 0.05. Result Sociodemographic characteristics Out of the total participants, 89.6% were aged between 10 and 18 years. Additionally, 58% of the participants identified as female. It is also noteworthy that 31.4% of the participants had a low Body Mass Index (BMI), indicating that a significant portion of this group may be underweight or have nutritional concerns (Table 1 ) . Table 1 Sociodemographic characteristics of Adherence, Effectiveness, Safety and Predictors of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025. Variable Category Prevalence Percent Age of client < 10 42 10.4 10–18 363 89.6 Sex of client Male 170 42.0 Female 235 58.0 Calculate BMI Under Weight 127 31.4 Normal 278 68.6 clinical and medication related condition Among the participants in the study, 11.9% had experienced a perinatal infection, which refers to infections occurring around the time of birth. Additionally, 30.1% of the participants were exposed to prevention of mother-to-child transmission (PMTCT) programs, indicating efforts to reduce the risk of transmitting infections from mothers to their infants. Regarding treatment, 89.6% of the participants received their treatment within a period of less than two years. This suggests that a significant majority of individuals were treated relatively quickly after diagnosis. Furthermore, 98.8% of the participants were on first-line treatment, which typically refers to the initial and most effective treatment regimen recommended for their condition. Awareness of their health status was high among the participants, with 98% reporting that they knew their medical status. This indicates effective communication and education about health within the group. In terms of previous health issues, 12.1% of the participants had a history of tuberculosis (TB) treatment, highlighting a past struggle with this infectious disease. Additionally, 13.3% had experienced opportunistic infections, which are infections that occur more frequently and with greater severity in individuals with weakened immune systems, further emphasizing the health challenges faced by some participants (Table 2 ). Table 2 Clinical and medication related condition of Adherence, Effectiveness, Safety and Predictors of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025. Variable Category Prevalence Percent Perinatal infection Yes 48 11.9 No 357 88.1 Children exposed to PMTCT Yes 122 30.1 No 283 69.9 ART treatment duration < 6 months 363 89.6 ≥ 6 months 42 10.4 Child aware of HIV status Yes 397 98.0 No 8 2.0 Regimen First Line 400 98.8 Second Line 5 1.2 History of TB treatment Yes 49 12.1 No 356 87.9 History of opportunity infection Yes 54 13.3 No 351 86.7 Family members' characteristics Out of the total participants, 81.2% had both alive parents. Additionally, 81.2% of the participants obtained care from parents. It is also noteworthy that 30.9% of the participants parent were HIV positive, and also 13.6% of participant had HIV positive sibling (Table 3 ). Table 3 Family members' characteristics of Adherence, Effectiveness, Safety and Predictors of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025. Variable Category Prevalence Percent Parents status Both alive 329 81.2 Only mother alive 69 17.0 Only father alive 5 1.2 Both are dead 2 0.5 Current caretake Father and mother 329 81.2 Mother only 71 17.5 Father only 3 0.7 Others 2 0.5 Parent HIV status Positive 125 30.9 Negative 280 69.1 Sibling HIV status Positive 55 13.6 Negative 350 86.4 Level of Adherence In total, 90.1% of participants had good adherence in the treatment follow-up (Fig. 1 ) Effectiveness of DTG Based Regimen Treatment At the time of initiating treatment with dolutegravir (DTG), 65.9% of the participants were classified as having Clinical Stage III according to the World Health Organization (WHO) guidelines, but after follow-up, most of the participants had Clinical Stage I and II according to the World Health Organization (WHO) guidelines were 67.4% and 32.6% respectively. When we look at viral loads, 97.8% of participants had viral loads greater than 200 copies per milliliter at the start of their Antiretroviral Therapy (ART). In contrast, the current evaluation shows that only 87.4% of participants now have viral loads below this threshold, indicating an improvement in viral suppression. Regarding CD4 counts, 51.6% of participants had CD4 counts below 200 cells per cubic millimeter at the initiation of ART. Currently, this has significantly improved, with participants now having CD4 counts of 350 or higher. This suggests a positive response to the treatment over time (Table 4 ). Table 4 Effectiveness of DTG Based Regimen Treatment of Adherence, Effectiveness, Safety and Predictors of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025. Variable Category Prevalence Percent WHO clinical stage at DTG initiation Stage I 7 1.7 Stage II 131 32.3 Stage III 267 65.9 Stage IV 0 0 Current WHO clinical stage Stage I 273 67.4 Stage II 132 32.6 Stage III 0 0 Stage IV 0 0 Baseline viral load (copies/ml) = 200 396 97.8 Current viral load (copies/ml) = 200 51 12.6 Baseline CD4 count (counts/mm3) =350 8 2.0 Current CD4 count (counts/mm3) =350 377 93.1 Safety of DTG Based Regimen Treatment The proportion of patients who reported ADEs following the DTG-based regimen was 33.3% (Fig. 2 ). Predictors of poor, had drug adverse effect and good effectiveness of DTG Based Regimen Treatment Level of Adherence The study performed a bivariate analysis to identify variables with p-values less than 0.25. This analysis included several factors, such as sex, body mass index (BMI), exposure to the prevention of mother-to-child transmission (PMTCT) programs, history of tuberculosis (TB) treatment, parents' HIV status, World Health Organization (WHO) stage, and adverse effects of treatment. These selected variables were then used in a multiple logistic regression analysis. The results indicated that sex, BMI and history of TB treatment were significantly associated with the poor adherence of DTG based regimen treatment among children and adolescents. Specifically, the subjects found that males were 73.8% less likely to demonstrate poor adherence to DTG-based treatment regimens than those with female (AOR = 0.262, 95% CI; 0.100, 0.685). Additionally, participants with a low BMI (classified as underweight) were found to be 4.3 times more likely to exhibit poor adherence to treatment than those with normal BMI (AOR = 4.305, 95% CI: 1.775, 10.438). Additionally, the participants had history of TB treatment 2.5 times more likely to poor adherence than had no history of TB treatment (AOR = 2.455, 95% CI; 1.385, 5.651). These findings highlight the importance of considering sex, BMI and history of tuberculosis (TB) treatment when evaluating adherence to treatment regimens (Table 5 ). Table 5 The predictor of level Adherence, of Dolutegravir-Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025. Variable Category Adherence COR 95% CI AOR 95% CI Good Poor Sex Female 201 34 1.0 1.0 Male 164 6 0.216(0.089, 0.528) 0.262(0.100, 0.685) * BMI Normal 261 17 1.0 1.0 Underweight 104 23 3.395(1.743, 6.614) 4.304(1.775, 10.438) * Exposed to PMTCT No 271 12 1.0 1.0 Yes 94 28 6.727(3.288, 13.762) 3.764(0.164, 8.219) History of TB treatment No 319 38 1.0 1.0 Yes 46 2 0.365(00.085, 1.564) 2.455(0.385, 5.651) * Parents HIV status Negative 268 12 1.0 1.0 Positive 97 28 6.45(3.154, 10.179) 0.857(0.048, 5.233) WHO stage Stage I 251 22 0.555(0.287, 1.075) 2.173(0.785, 6.019) Stage II 114 18 Stage III 0 0 Stage IV 0 0 1.0 1.0 Adverse effects of treatment No 260 10 1.0 1.0 Yes 105 30 7.429(3.507, 9.737) 2.619(0.658, 10.419) AOR: Adjusted Odds Ratio; COR: Crude Odds Ratio; CI: Confidence Interval Safety of DTG Based Regimen treatment The study performed a bivariate analysis to identify variables with p-values lower than 0.25. This analysis highlighted several important factors, including Sex, body mass index (BMI), exposure to prevention of mother-to-child transmission (PMTCT), Sibling HIV status, parents' HIV status, WHO stage, Level of Adherence, and CD4 Count. These variables were then selected for further examination using multiple logistic regressions. The results indicated that sex, sibling HIV status, Parents' HIV status, and WHO stage were significantly associated with the likelihood of the subjects having adverse effects of ART treatment. Specifically, the findings revealed that males were 6.4 times more likely to experience adverse effects from antiretroviral therapy (ART) as compared to females (AOR = 6.42, 95% CI 2.414, 11.076). Additionally, participants who had HIV-negative siblings were found to be 3.7 times more likely to face adverse effects from ART than those with HIV-positive siblings (AOR = 3.749, 95% CI: 1.09, 10.900). Conversely, participants with HIV-positive parents were significantly less likely, by 94%, to experience adverse effects from ART compared to those with HIV-negative parents (AOR = 0.004, 95% CI; 0.001, 0.012). Moreover, the study found that individuals who did have the Stage II and above after treatment were 4.2 times more likely to experience adverse effects from ART than those who did have Stage I (AOR = 4.183, 95% CI: 1.815, 9.641). These results underscore the complex interplay between various factors and the risk of experiencing adverse effects from ART (Table 6 ). Table 6 The predictor of Drug Adverse Effects, of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025. Variable Category Drug Adverse Effects COR 95% CI AOR 95% CI Yes No Sex Female 101 134 1.0 1.0 Male 34 136 3.015(1.911, 4.757) 6.42(2.414, 11.076) * BMI Normal 79 199 1.0 1.0 Underweight 56 71 0.503(0.325, 0.779) 0.351(0.134, 0.919) Exposed to PMTCT No 21 262 1.0 1.0 Yes 114 8 0.006(0.002, 0.013) 0.648(0.132, 1.431) Sibling HIV status Negative 100 250 0.229(0.126, 0.415) 3.749(1.09, 10.900) * Positive 35 20 1.0 1.0 Parents HIV status Negative 23 257 1.0 1.0 Positive 112 13 0.01(0.005, 0.021) 0.004(0.001, 0.012) * WHO stage after follow-up Stage I 72 201 1.0 1.0 Stage II and above 63 69 2.549(1.65, 3.937) 4.183(1.815, 9.641) * Level of Adherence No 30 10 1.0 1.0 Yes 105 260 7.429(3.507, 11.737) 2.467(1.601, 10.121) CD4 Count =350 122 255 0.552(0.255, 1.196) 0.307(0.090, 1.044) AOR: Adjusted Odds Ratio; COR: Crude Odds Ratio; CI: Confidence Interval Effectiveness of DTG Based Regimen Treatments The study performed a bivariate analysis to identify variables with p-values lower than 0.25. This analysis highlighted several important factors, including ART treatment duration, history of TB treatment, history of opportunistic infection, sibling HIV status, parents HIV status, and adverse effect. These variables were then selected for further examination using multiple logistic regression. The results indicated that ART treatment duration, history of opportunistic infection, sibling HIV status, and adverse effects were significantly associated with the likelihood of the subjects having the effectiveness of ART treatment. Specifically, the findings revealed that the subjects that had more than 1 year ART treatment duration were 1.8 times more likely to effective from antiretroviral therapy (ART) compared to those who had less than 1 year of art treatment duration, with an adjusted odds ratio (AOR = 1.831, 95% CI 1.105, 4.268). Additionally, participants who had HIV-positive siblings were found to be 2.3 times more likely to have effectiveness from ART than those without HIV-negative siblings (AOR = 2.325, 95% CI: 1.044, 5.180). Conversely, participants who had a history of opportunistic infection were 31% less likely to effective ART treatment compared to those who did not have a history of opportunistic infection (AOR = 0.69, 95% CI; 0.389, 0.978). Moreover, the study found that individuals who had drug adverse effects were 38.4% times less likely to effectiveness of ART treatment compared to had not have drug adverse effects (AOR = 0.616, 95% CI: 0.288, 0.815) (Table 7 ). Table 7 The predictor of Effectiveness, of Dolutegravir-Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025. Variable Category Effectiveness COR 95% CI AOR 95% CI Good Poor ART Treatment Duration ≥ 1 year 34 8 0.543(0.235, 1.252) 1.831 (1.105, 4.268) * < 1years 321 41 1.0 1.0 History of TB Treatment No 311 45 1.0 1.0 Yes 44 4 0.629(0.215, 1.832) 0.369(0.0821.655) History of opportunistic infection No 308 42 1.0 1.0 Yes 47 7 1.092(0.464, 2.573) 0.69(0.389, 0.978) * Sibling HIV status Negative 311 38 1.0 1.0 Positive 44 11 2.046(0.975, 4.295) 2.325 (1.044, 5.180) * Parents HIV status Negative 246 34 1.0 1.0 Positive 109 15 0.987(0.5160.998) 0.68 (0243, 1.047) Adverse effect No 235 35 1.0 1.0 Yes 120 14 0.777(0.403,0.899) 0.616 (0.288, 0.815) * AOR: Adjusted Odds Ratio; COR: Crude Odds Ratio; CI: Confidence Interval Discussion This study is one of the few conducted in Africa that evaluates how well children and adolescents with HIV adhere to, benefit from, and safely use DTG-based Highly Active Antiretroviral Therapy (HAART) regimens. The use of Dolutegravir (DTG) at a daily dose of 50 mg is recommended for children who weigh 20 kg or more. As a result, the majority of participants in this study—86%—were adolescents, specifically those aged between 10 and 15 years. The study found that a significant portion of participants (11.9%) were known to be perinatally infected with HIV. This percentage is notably lower than previous studies, which reported that nearly 75% of HIV-infected children were perinatally infected ( 19 ). Additionally, many of the patients in this study were experiencing advanced stages of HIV disease. This was indicated by the high percentage of participants classified at baseline with World Health Organization (WHO) stage 3 (65.9%) and a low number of CD4 + cell counts, with only 2.2% having counts below 200 cells/mm³. Most of the patients enrolled in the study did not have siblings who were HIV positive. In this context, a "sibling" refers to a child who shares the same biological parents as the primary patient. While Prevention of Mother-to-Child Transmission (PMTCT) programs have shown success when properly implemented, there is a pressing need to enhance strategies that expand service coverage. This includes increasing early diagnosis of HIV in infants, both immediately after birth and during breastfeeding. To effectively reduce the risk of HIV infection within families, especially in areas where HIV is widespread, it is crucial to adopt a family-centered approach in HIV care programs. This approach should focus on the well-being of the entire family unit. In this study, one adherence assessment methods were used to allow triangulation to overcome the respective limitations of each data. In total, 90.1% of participants had good adherence in the treatment follow-up. A similar study conducted in Ethiopia was 90% ( 33 ). And the finding was greater than the study of conducted in Tanzania was 71%( 19 ), but the study was lower than the study conducted in Dar Es Salaam was 97% ( 34 ), in western Kenya was 96.3% ( 35 ), in rural Uganda ( 36 ), and in Mbarara Regional Referral Hospital, 95.8% had a recorded good adherence in their files ( 37 ), in Bergamo Italy Overall, adherence, as calculated from PDC, was very high with a median of 99% ( 38 ). Reasons for this were that patients must come to terms with their HIV status-associated stigma and try to fit the drug regimen into their daily schedules ( 39 ). These factors are uncommon in children because they are not aware of their HIV status during diagnosis, as they were under the parent/guardian care, but as they age and become independent and aware of their HIV status, their level of adherence decreases due to the difficulty of coming to terms with the stigma associated with the condition. At the time of initiating treatment with dolutegravir (DTG), 65.9% of the participants were classified as having Clinical Stage III according to the World Health Organization (WHO) guidelines, but after follow-up, most of the participants had Clinical Stage I and II according to the World Health Organization (WHO) guidelines were 67.4% and 32.6% respectively. When we look at viral loads, 97.8% of participants had viral loads greater than 200 copies per milliliter at the start of their Antiretroviral Therapy (ART). In contrast, the current evaluation shows that only 87.4% of participants now have viral loads below this threshold, indicating an improvement in viral suppression. Regarding CD4 counts, 51.6% of participants had CD4 counts below 200 cells per cubic millimeter at the initiation of ART. Currently, this has significantly improved, with participants now having CD4 counts of 350 or higher. This suggests a positive response to the treatment over time. Other study, in Spain was 83.4% of patients were virologically suppressed ( 40 ), in sub-Saharan Africa was 67% of participants reported at least one ( 41 ), in French was (82%) ( 42 ), in Gondar Ethiopia was 91.7% ( 43 ), in Paris, France was 91.7% ( 44 ), in South-Western Uganda was the prevalence of virological suppression was 95.8% ( 37 ). The proportion of patients who reported ADEs following the DTG-based regimen was 33.3%. this finding was greater than the study conducted in Tanzania were 16.5%( 19 ), in France, two patients (4%) experienced neurological side effects during follow-up ( 42 ), in Paris, France was well tolerated; only one patient stopped treatment because of drug-related side effects ( 44 ), in Portugal was 4.4%) reported side effects ( 45 ), in California Dolutegravir was well tolerated, with all subjects experiencing at least one grade 1 or 2 transient clinical event ( 46 ). Adherence to antiretroviral therapy (ART) is essential for effectively managing HIV, particularly in children and adolescents. Various factors can significantly influence adherence, which can be categorized into two main groups: individual health and demographic factors, and psychosocial factors, based on recent studies. Children and adolescents with a low Body Mass Index (BMI) often face nutritional challenges that can hinder their overall health and ability to follow a treatment regimen. Being underweight may indicate insufficient nutritional support or underlying health problems, which can lead to fatigue and illness. This situation can create a cycle where poor adherence to ART worsens health issues. A history of tuberculosis (TB) treatment can also complicate the health of children and adolescents living with HIV. TB and HIV co-infection is common, and past TB treatments may result in lingering health effects, such as weakened immune function. These children might experience more frequent health problems, disrupting their ART adherence. Additionally, the psychological burden of having a serious illness like TB can further deter adherence to ongoing treatment. But Recent studies indicate that stigma (46.7%) is the leading reason for poor adherence in this population, followed by travel difficulties (33.3%) and alcohol use (20.0%). Factors such as age (children between 10 and 15 years), knowledge of HIV status, having a CD4 count of 500 or more, and the presence of comorbid illnesses are also significant predictors of poor adherence to the dolutegravir (DTG)-based ART regimen in children and adolescents. The use of Dolutegravir (DTG)-based antiretroviral therapy (ART) has become a standard approach for managing HIV in children and adolescents. However, several factors can lead to adverse drug reactions in this population. This discussion highlights key influences, such as the health status of siblings and parents, the clinical stage of the treatment, and the patient's sex. Children with HIV-negative siblings may experience emotional challenges that affect their treatment adherence and overall health, potentially increasing the risk of side effects. Similarly, when parents are HIV positive, children might face heightened anxiety about their own health and familial responsibilities, complicating their care and support systems. Moreover, those at the end of the follow-up, the Stage II or higher of the WHO classification, are more likely to experience adverse effects due to higher viral loads and greater immunosuppression, which can intensify the body's response to ART. Understanding these factors is crucial for optimizing treatment and support for young patients living with HIV. This study investigates the effectiveness of Dolutegravir (DTG)-based antiretroviral therapy (ART) in children and adolescents, revealing several key predictors that influence successful treatment outcomes. One significant factor is the duration of treatment: patients who remain on ART for over a year tend to experience better health and viral suppression, indicating that prolonged exposure stabilizes their condition. Additionally, Children and adolescents who have a history of opportunistic infections (OIs) do not show improvement when using DTG. This suggests that while DTG has strong antiviral effects, it may not be effective in preventing these infections from returning. Having an HIV-positive sibling also correlates with better outcomes, likely due to enhanced family support and increased awareness of HIV management. But the other study, treatment adherence is crucial, particularly for those aged 10–14, who may face challenges in maintaining consistent medication routines. The study also highlights that remaining in care is essential for successful treatment, as regular medical oversight supports adherence. Malnutrition presents a significant barrier, as it can weaken the immune system, reducing the effectiveness of ART. Socioeconomic factors, such as living in coastal areas, may also affect access to healthcare and nutritional resources. Lastly, factors like the WHO clinical stage at diagnosis and multi-month prescriptions can enhance treatment effectiveness by promoting adherence and reducing the need for frequent healthcare visits. This study's primary drawback is its observational design, which makes it vulnerable to bias due to unmeasured confounders. However, this may have been lessened by the study participants' very high sample size. The presented results might have been improved by using two approaches to measure drug adherence, particularly the pharmacy-refill method. Conclusion This study found that using dolutegravir (DTG)-based antiretroviral therapy (ART) in children and adolescents is safe, with only minor adverse drug events (ADEs) reported. Moreover, the DTG regimen has proven effective for this age group, including those who have previously undergone treatment and had high viral loads before switching to DTG therapy. Additionally, most children and adolescents demonstrated good adherence to the DTG treatment regimens. List of Abbreviations ADE Adverse Effect AIDS Acquired Immune Deficiency Syndrome DCSTH Dessie Comprehensive Specialized Hospital DTCSH Debre Tabor Comprehensive Specialized Hospital DTG Dolutegravir EFV Efavirenz INSTI Integrase Strand Transfer Inhibitors HIV Human Immunodeficiency Virus FHCSH Felege Hiwot Comprehensive Specialized Hospital WCSH Woldia Comprehensive Specialized Hospital WHO World Health Organization Declarations Ethics approval Ethical approved by the Institutional Review Board (IRB) of the College of Health Sciences, Woldia University with reference number 629/25, and Ethiopian Public Health Institute Amhara region branch (APHI) with reference number -APHI/M/l/D/-T-03/807-03/807 to conduct the study. Ethics approval and consent to participate in this study were confirmed by the IRB of College of Health Sciences, Woldia University, and APHI confirming that all the methods were performed according to the rules and regulations of the IRB, Hospitals, and by the 1964 Helsinki Declaration. Informed consent was impracticable to this study. This study was done by the Helsinki Declaration which stated that “medical research using identifiable human material or data, physicians must normally seek consent for collection, analysis, and storage and/or reuse. There may be conditions where obtaining informed consent from the participants would be impossible or impracticable and threaten the validity of the research. In this instance, the research may be done after considerations and approval of the IRB”. The ethical approvals were submitted to study area hospitals. Letters of permission were also obtained from the hospitals. Finally, permission letters were submitted to the hospitals’ ART Clinic card rooms. Thus, the informed consent of the participants was waived by the IRB of the College of Health Sciences, Woldia University and APHI. The collected data were kept anonymous and confidentiality was maintained. Consent for publication Not applicable. Competing interests The authors declare that they have no any competing interests. Funding Financial support for data collection was obtained from University of Woldia. The funding institution has no any role in the designing and acquisition of this study and preparation of the manuscript as well as the decision to publish. Availability of data and materials The datasets generated during the current study are not publicly available due to confidentiality issues since the study was conducted among children and adolescent. But data will be available upon reasonable request from the corresponding author. Authors' contributions DT worked on developing the research idea, designing the study, being involved in proposal writing, training and supervising the data collectors, analyzing and interpreting the results, and preparing the manuscript. YAD, TM, FDB and ADG played their role in critically revising the proposal, participating in its design, analyzing and interpreting the results, and writing the manuscript. All authors were involved in reading and approving the final manuscript. Acknowledgement First, we would like to thank Woldia University College of health sciences, department of pediatrics and child health nursing for giving a chance to conduct this research. Also, we would like to thank Amhara Regional State public hospital staffs and data collectors for giving necessary information. Our special thanks go to for data collectors without whom it may not possible to accomplish this study. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8707598","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":585916913,"identity":"7b35645b-10bf-40f9-915d-091c75dc3aac","order_by":0,"name":"Dagnew Tigabu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9klEQVRIiWNgGAWjYDACZhgCgQ9AzMZOQAcPshbGGSAtzIS0MCBpYeaB2osX2LOzX/xc2GYtLx/dfEza5tc2eT5mBsYPH3PwOYynWHpmW7rhxjvH0qRz+24btjEzMEvO3IZXS4I0b9thxo0zcsxu5/bcZgRqYWPmxa8l+TdQi/3GGfnfblv23LYnQgv7MZAtifMlcthuM/y4nUhYy2EeNusZ59KTN0ikmf/sbbid3MbM2IzXL+z9xx/fLiiztp0/I/mxwY8/t23ntzcf/PARjxagPQZgyuAAkGBsAzEZG/CpB9nzAEzJg9X9IaB4FIyCUTAKRiQAAOSOTPEoJQZ5AAAAAElFTkSuQmCC","orcid":"https://orcid.org/0009-0002-1821-6865","institution":"Woldia University","correspondingAuthor":true,"prefix":"","firstName":"Dagnew","middleName":"","lastName":"Tigabu","suffix":""},{"id":585916914,"identity":"48e05fc9-467b-4570-9918-92805e737af1","order_by":1,"name":"Yabibal Asfaw Derso","email":"","orcid":"","institution":"Woldia 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University","correspondingAuthor":false,"prefix":"","firstName":"Abraham","middleName":"Dessie","lastName":"Gessesse","suffix":""},{"id":585916918,"identity":"ba35cf65-0027-4487-9eaf-acc21e1f3a91","order_by":5,"name":"Lemlem Ewunetu","email":"","orcid":"","institution":"Amhara Regional Health Bureau: Amhara National Regional Health Bureau","correspondingAuthor":false,"prefix":"","firstName":"Lemlem","middleName":"","lastName":"Ewunetu","suffix":""}],"badges":[],"createdAt":"2026-01-27 08:09:38","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8707598/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8707598/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102296952,"identity":"6a078d6a-6478-43b6-8d77-240e13f724b5","added_by":"auto","created_at":"2026-02-10 10:23:15","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":18220,"visible":true,"origin":"","legend":"\u003cp\u003eLevel of adherence of Dolutegravir-Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8707598/v1/97fb73f06d5c7c87633b5cd9.png"},{"id":102212530,"identity":"ac1f8092-a1e3-48fa-b066-c3c2ae4ddd95","added_by":"auto","created_at":"2026-02-09 12:34:07","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":17255,"visible":true,"origin":"","legend":"\u003cp\u003ethe adverse effect of Dolutegravir Based Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8707598/v1/b88b8d22e865e3ac12d6af22.png"},{"id":104404001,"identity":"ffe2adc1-1e21-4dd7-97b3-93626e53d54c","added_by":"auto","created_at":"2026-03-11 12:19:34","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1300560,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8707598/v1/0e5a7860-5bf1-4e6b-81c2-ca58369c5f5b.pdf"}],"financialInterests":"","formattedTitle":"Adherence, Effectiveness, Safety and Predictors of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia: Retrospective Follow up Study.","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAt least two nucleosides (nucleotide reverse transcriptase inhibitors) and a third medicine from any of the following pharmacological classes have constituted the cornerstone of HIV treatment: Protease inhibitors (PIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), and integrase strand transfer inhibitors (INSTIs), such as dolutegravir (DTG) and raltegravir (RAL). HIV infection is now regarded as a chronic illness that may be controlled over time rather than a deadly condition because of the use of antiretroviral medication (ART) (\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDolutegravir (DTG) is a member of the relatively new class of antiretroviral treatment (ART) drugs known as integrase strand transfer inhibitors (INSTIs). The mechanism of action terminates the life cycle of the virus by preventing the integration of HIV nucleic acid into the genome of the host T-lymphocyte. The main uses of raltegravir, the first INSTI to register with the South African Health Products Regulatory Authority (SAHPRA), were in third-line regimens and as salvage therapy for patients who did not react to second-line regimens based on protease inhibitors. Since then, the third drug to be approved for use as first-line therapy is efavirenz (EFV), which is administered in conjunction with two nucleoside/nucleotide reverse transcriptase inhibitors. EFV will basically be replaced by DTG. DTG is associated with better viral suppression, fewer drug-drug interactions, and a decreased chance of drug resistance mutations emerging as compared to EFV (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDTG is a crucial antiretroviral drug that has emerged as the mainstay of many HIV programs, especially those in sub-Saharan Africa. It has recently replaced efavirenz as the third drug that is advised for patients beginning antiretroviral therapy in South Africa. Its cost-effectiveness, tolerability, and favorable resistance profile have affected HIV care worldwide, including the most recent revision to WHO antiretroviral guidelines. However, making educated decisions is essential, just like with any drug. Despite the many advantages of DTG, recent studies have revealed risks that exceed advantages, thus a doctor should carefully balance these before recommending DTG. This essay's goal is to give primary care physicians a summary of the benefits and drawbacks of South Africa's DTG rollout(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSub-Saharan Africa continues to be the region most severely impacted by HIV/AIDS, one of the worst public health issues in the world. At the end of 2020, 150,000 children were newly infected, and an estimated 1.8 (1.2\u0026ndash;2.2) million children aged 0\u0026ndash;14 lived with HIV. An estimated 100,000 youngsters perished from diseases linked to AIDS (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAs of July 2019, the World Health Organization (WHO) recommended integrase inhibitor DTG as the preferred first- and second-line treatment for HIV in all populations, including those who are or may become pregnant(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Since then, several low- and middle-income countries have changed their policy to use DTG-based HIV treatment regimens instead of EFV-based first-line ART. DTG is now the recommended drug for patients starting ART for the first time, those experiencing EFV side effects, and those who choose to use DTG, according to a 2020 revision of South Africa's national HIV guidelines. Benefits of new medications in the ART arsenal are anticipated to include reduced costs, fewer tablets consumed, decreased viral load, fewer side effects, and a stronger genetic barrier to resistance (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eQuick absorption, a once-daily dosage requirement, and the option to take DTG with or without food are all features of its posology. There is no need for pharmacological boosting (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). mpaired renal function has no appreciable impact on the pharmacokinetics of DTG because of its low urine excretion (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). A prescription for DTG (50 mg tablet) or a fixed dose combination of 300 mg of tenofovir disoproxil fumarate (TDF) and 300 mg of lamivudine (3TC) may be given to those who weigh more than 35 kg and are older than 10 years. DTG's efficacy and improved safety profile were demonstrated in numerous clinical trials conducted on both ART-naive and ART-experienced participants (\u003cspan additionalcitationids=\"CR10 CR11\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe FDA recently approved dolutegravir, the most recent INSTI, in a single-tablet regimen (STR) with abacavir and lamivudine(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). You can take dolutegravir once daily. Nowadays, dolutegravir is one of the first antiretroviral regimens that is advised, along with either abacavir-lamivudine or tenofovir-emtricitabine (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDespite the undeniable effectiveness of ART, some problems still exist. Patients will have to take the medications for the rest of their lives since they are unable to fully eradicate the virus, which puts them at risk for harmful side effects, drug interactions, and drug resistance(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). In many low- and middle-income nations overall, this nonadherence may contribute to an increase in pretreatment HIV medication resistance, treatment failure, and resource waste among individuals starting or continuing first-line ART (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEthiopia's Ministry of Health (MOH) has advised adults, adolescents, and expectant mothers to use TDF+3TC\u0026thinsp;+\u0026thinsp;DTG (TLD) as their first-line ART regimen from 2019. Compared to fixed-dose combinations (FDC), TLD is a simpler, less hazardous, more convenient, and more efficient regimen. DTG's efficacy has been demonstrated in numerous randomized controlled trials with individuals who have never used ART before as well as those who have (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e64.5% of patients had sustained suppression for six months, and 66.7% of patients had a viral load\u0026thinsp;\u0026lt;\u0026thinsp;50 copies/ml at the one-year follow-up. The baseline and 6-month viral load counts were substantially correlated with viral suppression at the one-year follow-up. At baseline and at 6-month follow-up, 60.6% and 57.9% of the 38 patients who did not achieve virological suppression after a year, respectively, had viral loads greater than 50 copies/ml. After six and one years of follow-up, the rates of virological failure (viral load\u0026thinsp;\u0026gt;\u0026thinsp;1000 copies/ml) were 16.2% and 16.5%, respectively (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAccording to self-report, the 200 patients evaluated in a prospective cohort trial in Tanzania had high (48%), moderate (40.5%), and poor (11.5%) adherence rates(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Patients who were new to ART had a greater self-reported adherence rate (69%) than those who had previously received treatment (44.4%). 71% of individuals were found to be highly adherent to the DTG-based HAART regimens using the drugstore refill. Additionally, ART-na\u0026iuml;ve individuals (82.8%) showed higher levels of adherence than patients with prior treatment experience (69%). According to the self-reporting assessment, only 51.4% of the 142 patients who had high adherence based on pharmacy refills also had high levels of adherence (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe overall cohort's mean CD4\u0026thinsp;+\u0026thinsp;cell counts at baseline were 595 cells/mm3. Thirteen percent of the patients had CD4\u0026thinsp;+\u0026thinsp;cell counts below 200 cells/mm3. Additionally, the mean CD4\u0026thinsp;+\u0026thinsp;cell counts six months after starting DTG-based HAART regimens were 567.5 cells/mm3, with only 6% of patients having a CD4\u0026thinsp;+\u0026thinsp;count below 200 cells/mm3. After beginning a DTG-based treatment, all patients with CD4\u0026thinsp;+\u0026thinsp;cell counts below 200 cells/mm3 had low baseline CD4\u0026thinsp;+\u0026thinsp;cell counts. Between baseline and six months following the DTG-based regimen, the average difference in CD4\u0026thinsp;+\u0026thinsp;cell counts was 0.63 cells/mm3. Furthermore, overall, 70.2% of individuals had an undetectable viral load six months after starting DTG-based HAART regimens (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eA retrospective cohort study of Tanzanian children and adolescents found that 91.64% of them had viral suppression. In total, 88.45% of previously suppressed people remained repressed, and 66.19% of previously unsuppressed people were suppressed (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTwo patients (1 and 2) stopped taking ART during follow-up, necessitating unplanned clinical visits. The viral load peaks for patients 1 and 2 were 1779 and 4100 copies/ml, respectively. At later visits, we saw virologic suppression as a result of better adherence to ART and a quicker reaction to DTG-based ART after talking with both patients about the significance of adherence and the dangers of developing further drug resistance mutations (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOverall, 78.8% of patients experienced persistent virological suppression during follow-up, and 88.1% of people had viraemia suppressed at the last visit, per a retrospective follow-up research conducted in France (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAlthough the overall rate of side effects is close to 90%, this optimistic estimate includes mostly minor reactions that mostly go away over time and might not be totally drug-related. Although headache, nausea, and diarrhea are common side effects, only 1% of patients experience severe reactions (grade III or IV) (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Additionally, less than 2% of adverse events attributed to dolutegravir resulted in treatment discontinuation, which is similar to raltegravir and lower than efavirenz and PI-based regimens (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). In individuals with prior treatment experience, there was no change in the overall frequency of adverse events or the frequency of adverse events that resulted in drug cessation when compared to raltegravir (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Dolutegravir has not been associated with an increase in cardiovascular risk (\u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Further proof of the tolerability of dolutegravir is the similar side effect profile observed when given twice daily, even among those with advanced immunosuppression (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOnly one patient discontinued therapy due to dolutegravir-related adverse effects (dizziness and sleep problems), indicating that the medication was well tolerated. The three grade 3 laboratory events (acute liver abnormalities that went away without dolutegravir stoppage) were deemed unrelated to the drug. There were no AIDS-related incidents or fatalities (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eA retrospective cohort study in Tanzania found that children and adolescents aged 10\u0026ndash;14 and 5\u0026ndash;9 years were 2% less likely to achieve HIV viral suppression than those aged 1\u0026ndash;4 years. Participants in WHO Stage I were 1.03 times more likely to be virally suppressed than those in Stage IV. Previously unsuppressed individuals had an 8% lower likelihood of achieving suppression compared to those who were previously suppressed. Those on antiretroviral therapy (ART) for over 24 months were 4% less likely to achieve suppression than those on ART for 24 months or less. Participants with a multi-month subscription were 1.25 times more likely to achieve viral suppression than those without. Additionally, individuals not retained in care were 17% less likely to be virally suppressed, and those with severe nutritional issues were 23% less likely to achieve suppression compared to those without malnutrition. Conversely, participants living in the coastal zone were 2% less likely to achieve viral suppression than those in the western zone (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn accordance with the WHO's recommendation, the Ethiopian government has included DTG-based regimens in the 2018 National Comprehensive HIV Prevention, Care, and Treatment Guidelines as part of its ongoing efforts to prevent HIV transmission and enhance the quality of HIV care and treatment services (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Tenofovir/Lamivudine/Dolutegravir (TLD) use started in Ethiopia in February 2019 and was first introduced in the research domain (Lumame Primary Hospital) on April 1, 2019.6 However, there are currently no published studies evaluating the appropriate use of ART medications such as the TLD in Ethiopia; therefore, drug use patterns help identify gaps in medication use and implement initiatives that promote responsible drug consumption (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). s\u003c/p\u003e \u003cp\u003e In Ethiopia, changes are being made to the treatment guidelines based on the evidence regarding treatment Adherence, efficacy and safety. Such changes call for economic evaluations to investigate the cost effectiveness of the newly introduced regimen and to examine whether the added cost of therapy can be justified by the added benefit. However, the new regimen is being implemented without a proper economic evaluation of its costs and outcomes in the Ethiopian context. This study therefore aimed to evaluate the cost effectiveness of replacing an EFV-based regimen with a DTG-based regimen as a preferred first-line treatment for HIV/AIDS patients in the Ethiopian context.\u003c/p\u003e"},{"header":"Methods and Materials","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design, area and period\u003c/h2\u003e \u003cp\u003e An institution-based retrospective follows up study will be conducted in Amhara Regional State Comprehensive Hospitals, at Tibebe Ghion, Felege Hiwot, Gondar, Debre Tabor, Debre Markos, Woldia, Dessie and Debre Birhan specialized hospitals in Amhara Regional State. Currently the state has eight comprehensive specialized hospitals. From the total eight Specialized Hospitals only four Specialized Hospitals are selected for study area by lottery methods. The Four these hospitals (Debre Tabor, Felege Hiwot, Woldia and Dessie) are selected, that serving for more than 5\u0026nbsp;million people each and organized in different wards; medical ward, surgical ward, gynecology and obstetrics ward, orthopedics ward, oncology ward, pediatric ward, intensive care unit, NICU and different outpatient departments. FHCSH the total currently on DTG regimen are 213. Debre Tabor Comprehensive specialize hospital the total currently on DTG regimen are 153. Dessie Comprehensive specialize hospital the total currently on DTG regimen are 318. Woldia Comprehensive specialize hospital the total currently on DTG regimen are 179. The study conducted in 2025 G. C.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003ePopulation selection and participation\u003c/h3\u003e\n\u003cp\u003e All records of children and adolescent who\u0026rsquo;s weighing \u0026ge;\u0026thinsp;20kg and attending in ART clinics with on DTG based regimen therapy of selected public hospitals of Amhara Regional State during the study period were included. Unfortunately, all children and adolescent with incomplete medical records (incomplete Viral load, non-DTG based regimen and adverse effect records), Children and adolescents with co-morbidities like diabetes mellitus, tuberculosis (TB), liver disease, renal disease, and malaria were excluded. Patients taking medicines that are likely to interact with DTG, such as herbal supplements, antacids, and ferrous sulfate, were excluded.\u003c/p\u003e\n\u003ch3\u003eSample size determination, Sampling Technique and Procedure\u003c/h3\u003e\n\u003cp\u003eUsing Double population proportion formula was used to calculate the sample size by using independent predictors of poor adherence, effectiveness and had adverse drug effect of Dolutegravir based antiretroviral regimens from previous study conducted with 95% CI, a power of 80% and 1:1 ratio of exposed to non-expos (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). By considering 10% for non-response rate, the total sample size was \u003cb\u003e403\u003c/b\u003e using Epi-info version 7.2.6 was used to calculate sample size.\u003c/p\u003e \u003cp\u003eAll HIV infected children and adolescent who attending ART clinic with DGT based regimen therapy from July 01/2014 to June 30/20156 E.C were included in the study. Firstly, All HIV infected children and adolescent who attending ART clinic with DGT based regimen therapy card numbers obtained from ART clinic registration logbook. The overall total number of participants in three hospitals was 863. All participants medical registration number were listed with a sample frame from 1 up to 863. Then proportional allocation of sample taking for each hospital was calculated by using a proportional allocation formula. So that, the sample sizes drawn from Felege Hiwot, Debre Tabor Woldia and Dessie specialized hospitals are 100, 71, 84 and 148, respectively. Finally, the study subjects for each hospital selected by simple random sampling technique using the list as a sampling frame.\u003c/p\u003e\n\u003ch3\u003eData Extraction Tool, Procedure and Quality Control\u003c/h3\u003e\n\u003cdiv class=\"Heading\"\u003eData Extraction Tool, Procedure and Quality Control\u003c/div\u003e \u003cp\u003eThe data was collected using a checklist adapted from previous literature (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). This checklist included: socio-demographic factors, clinical and medication-related factors and family member influences on poor adherence, effectiveness, and drug adverse effects. Two weeks prior to the actual data collection, the checklist was pretested on 5% of the sample size in a location outside the study area with a similar population. Additionally, a two-day training session was provided for data collectors and supervisors, covering the data collection tools and the study's objectives. Trained data collectors gathered the data using the checklist, while supervisors and the principal investigator closely monitored the entire process and reviewed daily submission reports.\u003c/p\u003e\n\u003ch3\u003eStudy Variables and Their Measurements\u003c/h3\u003e\n\u003cp\u003eThe outcome variable was Adherence, effectiveness, safety and Predictors of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals and this was measured as adherence, effectiveness and safety of DTG regimen therapy (good/poor, good or poor and had drug adverse effect or not) respectively.\u003c/p\u003e \u003cp\u003e \u003cb\u003eAdherence: -\u003c/b\u003e Adherence was assessed using self-reporting and pharmacy refill methods by calculated, number of days for the pills dispensed previously- delay in days for next pickup / number days for the pills dispensed previously * 100 in the three months intervals for the period of one year (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cb\u003eGood ART adherence\u003c/b\u003e-equal to or greater than 95% adherence i.e., missing up to 2 out of 30 doses or up to 4 from the 60 doses implies good adherence (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cb\u003ePoor ART adherence\u003c/b\u003e-less than 95% adherence, i.e., missing\u0026thinsp;\u0026gt;\u0026thinsp;5 doses out of 30 doses or \u0026gt;\u0026thinsp;10 doses from 60 doses implies poor adherence (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cb\u003eEffectiveness: -\u003c/b\u003e The CD4\u0026thinsp;+\u0026thinsp;cell counts and viral load data were obtained from the patient\u0026rsquo;s laboratory data. The viral load was measured using the Abbott Real-Time HIV-1 (Abbott Molecular Diagnostics, Wiesbaden, Germany) with a minimum detection level of \u0026lt;\u0026thinsp;50 copies/ml. These data were collected at baseline, 6 months, and 1 year after initiating the DTG-based HAART regimen (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cb\u003eGood :-\u003c/b\u003e the result of the laboratory finding of viral load was \u0026lt;\u0026thinsp;50 copies/ml, \u0026le;\u0026thinsp;2 WHO stage and had\u0026thinsp;\u0026ge;\u0026thinsp;200 of CD4 count (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cb\u003ePoor :-\u003c/b\u003e the result of the laboratory finding of viral load was \u0026ge;\u0026thinsp;50 copies/ml\u0026thinsp;\u0026gt;\u0026thinsp;2 WHO stage and had\u0026thinsp;\u0026le;\u0026thinsp;200 of CD4 count (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cb\u003eSafety: -\u003c/b\u003e is monitored based on the incidence and severity of adverse drug events (ADEs) and toxicity based on the abnormal range of laboratory tests and spontaneous reporting (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cb\u003eFollow-up time: -\u003c/b\u003e at the time enrolled in the DTG-based regimen, up to 1 year.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData Processing and Analysis\u003c/h2\u003e \u003cp\u003eStatistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 25. Before conducting the study, continuous variables were log-transformed to meet statistical assumptions. Descriptive statistics were used to summarize both clinical and laboratory results. Continuous variables were expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (\u0026plusmn;\u0026thinsp;SD), while frequencies and percentages represented categorical variables. The primary outcome of the study was the percentage of patients who adhered to at least 95% of the DTG-based antiretroviral therapy (ART) regimen within one year. Secondary outcomes included the percentage of patients who maintained a viral load of less than 50 copies/ml after one year. Safety outcomes involved the percentage of patients who reported adverse drug events (ADEs) while on DTG-based highly active antiretroviral therapy (HAART) regimens, as well as those who had laboratory results outside the normal range. To identify predictors of achieving poor adherence (\u0026lt;\u0026thinsp;95%) of using the drug, the participants had effective outcomes based on a DTG-based regimen, and also had no drug adverse effects within one year. A binary logistic regression model was utilized. Results were considered statistically significant if the p-value was less than 0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"Result","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eSociodemographic characteristics\u003c/h2\u003e \u003cp\u003eOut of the total participants, 89.6% were aged between 10 and 18 years. Additionally, 58% of the participants identified as female. It is also noteworthy that 31.4% of the participants had a low Body Mass Index (BMI), indicating that a significant portion of this group may be underweight or have nutritional concerns (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSociodemographic characteristics of Adherence, Effectiveness, Safety and Predictors of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePrevalence\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAge of client\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u0026ndash;18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e363\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e89.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex of client\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e170\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e235\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCalculate BMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnder Weight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e278\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eclinical and medication related condition\u003c/h2\u003e \u003cp\u003eAmong the participants in the study, 11.9% had experienced a perinatal infection, which refers to infections occurring around the time of birth. Additionally, 30.1% of the participants were exposed to prevention of mother-to-child transmission (PMTCT) programs, indicating efforts to reduce the risk of transmitting infections from mothers to their infants. Regarding treatment, 89.6% of the participants received their treatment within a period of less than two years. This suggests that a significant majority of individuals were treated relatively quickly after diagnosis. Furthermore, 98.8% of the participants were on first-line treatment, which typically refers to the initial and most effective treatment regimen recommended for their condition. Awareness of their health status was high among the participants, with 98% reporting that they knew their medical status. This indicates effective communication and education about health within the group. In terms of previous health issues, 12.1% of the participants had a history of tuberculosis (TB) treatment, highlighting a past struggle with this infectious disease. Additionally, 13.3% had experienced opportunistic infections, which are infections that occur more frequently and with greater severity in individuals with weakened immune systems, further emphasizing the health challenges faced by some participants (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinical and medication related condition of Adherence, Effectiveness, Safety and Predictors of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePrevalence\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePerinatal infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e357\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e88.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eChildren exposed to PMTCT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e283\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e69.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eART treatment duration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;6 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e363\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e89.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;6 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eChild aware of HIV status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e397\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e98.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eRegimen\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFirst Line\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e400\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e98.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecond Line\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHistory of TB treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e356\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e87.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHistory of opportunity infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e351\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eFamily members' characteristics\u003c/h2\u003e \u003cp\u003eOut of the total participants, 81.2% had both alive parents. Additionally, 81.2% of the participants obtained care from parents. It is also noteworthy that 30.9% of the participants parent were HIV positive, and also 13.6% of participant had HIV positive sibling (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFamily members' characteristics of Adherence, Effectiveness, Safety and Predictors of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePrevalence\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eParents status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth alive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e329\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e81.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOnly mother alive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOnly father alive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBoth are dead\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eCurrent caretake\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFather and mother\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e329\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e81.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMother only\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFather only\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eParent HIV status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e280\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e69.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSibling HIV status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eLevel of Adherence\u003c/h2\u003e \u003cp\u003eIn total, 90.1% of participants had good adherence in the treatment follow-up (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eEffectiveness of DTG Based Regimen Treatment\u003c/h2\u003e \u003cp\u003e At the time of initiating treatment with dolutegravir (DTG), 65.9% of the participants were classified as having Clinical Stage III according to the World Health Organization (WHO) guidelines, but after follow-up, most of the participants had Clinical Stage I and II according to the World Health Organization (WHO) guidelines were 67.4% and 32.6% respectively. When we look at viral loads, 97.8% of participants had viral loads greater than 200 copies per milliliter at the start of their Antiretroviral Therapy (ART). In contrast, the current evaluation shows that only 87.4% of participants now have viral loads below this threshold, indicating an improvement in viral suppression. Regarding CD4 counts, 51.6% of participants had CD4 counts below 200 cells per cubic millimeter at the initiation of ART. Currently, this has significantly improved, with participants now having CD4 counts of 350 or higher. This suggests a positive response to the treatment over time (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eEffectiveness of DTG Based Regimen Treatment of Adherence, Effectiveness, Safety and Predictors of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePrevalence\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eWHO clinical stage at DTG initiation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage I\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e267\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage IV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eCurrent WHO clinical stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage I\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e273\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage IV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBaseline viral load (copies/ml)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;= 200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e396\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e97.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCurrent viral load (copies/ml)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e354\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e87.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;= 200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eBaseline CD4 count (counts/mm3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200\u0026ndash;350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e188\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;=350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eCurrent CD4 count (counts/mm3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200\u0026ndash;350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;=350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e377\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eSafety of DTG Based Regimen Treatment\u003c/h2\u003e \u003cp\u003eThe proportion of patients who reported ADEs following the DTG-based regimen was 33.3% (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003ePredictors of poor, had drug adverse effect and good effectiveness of DTG Based Regimen Treatment\u003c/h2\u003e \u003cdiv id=\"Sec17\" class=\"Section3\"\u003e \u003ch2\u003eLevel of Adherence\u003c/h2\u003e \u003cp\u003eThe study performed a bivariate analysis to identify variables with p-values less than 0.25. This analysis included several factors, such as sex, body mass index (BMI), exposure to the prevention of mother-to-child transmission (PMTCT) programs, history of tuberculosis (TB) treatment, parents' HIV status, World Health Organization (WHO) stage, and adverse effects of treatment. These selected variables were then used in a multiple logistic regression analysis. The results indicated that sex, BMI and history of TB treatment were significantly associated with the poor adherence of DTG based regimen treatment among children and adolescents. Specifically, the subjects found that males were 73.8% less likely to demonstrate poor adherence to DTG-based treatment regimens than those with female (AOR\u0026thinsp;=\u0026thinsp;0.262, 95% CI; 0.100, 0.685). Additionally, participants with a low BMI (classified as underweight) were found to be 4.3 times more likely to exhibit poor adherence to treatment than those with normal BMI (AOR\u0026thinsp;=\u0026thinsp;4.305, 95% CI: 1.775, 10.438). Additionally, the participants had history of TB treatment 2.5 times more likely to poor adherence than had no history of TB treatment (AOR\u0026thinsp;=\u0026thinsp;2.455, 95% CI; 1.385, 5.651). These findings highlight the importance of considering sex, BMI and history of tuberculosis (TB) treatment when evaluating adherence to treatment regimens (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe predictor of level Adherence, of Dolutegravir-Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eAdherence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCOR 95% CI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAOR 95% CI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.216(0.089, 0.528)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.262(0.100, 0.685) *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e261\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnderweight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.395(1.743, 6.614)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.304(1.775, 10.438) *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eExposed to PMTCT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e271\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.727(3.288, 13.762)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.764(0.164, 8.219)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHistory of TB treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e319\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.365(00.085, 1.564)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.455(0.385, 5.651) *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eParents HIV status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e268\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.45(3.154, 10.179)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.857(0.048, 5.233)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eWHO stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage I\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.555(0.287, 1.075)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.173(0.785, 6.019)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage IV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAdverse effects of treatment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e260\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.429(3.507, 9.737)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.619(0.658, 10.419)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eAOR: Adjusted Odds Ratio; COR: Crude Odds Ratio; CI: Confidence Interval\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eSafety of DTG Based Regimen treatment\u003c/h2\u003e \u003cp\u003eThe study performed a bivariate analysis to identify variables with p-values lower than 0.25. This analysis highlighted several important factors, including Sex, body mass index (BMI), exposure to prevention of mother-to-child transmission (PMTCT), Sibling HIV status, parents' HIV status, WHO stage, Level of Adherence, and CD4 Count. These variables were then selected for further examination using multiple logistic regressions.\u003c/p\u003e \u003cp\u003eThe results indicated that sex, sibling HIV status, Parents' HIV status, and WHO stage were significantly associated with the likelihood of the subjects having adverse effects of ART treatment. Specifically, the findings revealed that males were 6.4 times more likely to experience adverse effects from antiretroviral therapy (ART) as compared to females (AOR\u0026thinsp;=\u0026thinsp;6.42, 95% CI 2.414, 11.076). Additionally, participants who had HIV-negative siblings were found to be 3.7 times more likely to face adverse effects from ART than those with HIV-positive siblings (AOR\u0026thinsp;=\u0026thinsp;3.749, 95% CI: 1.09, 10.900). Conversely, participants with HIV-positive parents were significantly less likely, by 94%, to experience adverse effects from ART compared to those with HIV-negative parents (AOR\u0026thinsp;=\u0026thinsp;0.004, 95% CI; 0.001, 0.012). Moreover, the study found that individuals who did have the Stage II and above after treatment were 4.2 times more likely to experience adverse effects from ART than those who did have Stage I (AOR\u0026thinsp;=\u0026thinsp;4.183, 95% CI: 1.815, 9.641). These results underscore the complex interplay between various factors and the risk of experiencing adverse effects from ART (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe predictor of Drug Adverse Effects, of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eDrug Adverse Effects\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCOR 95% CI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAOR 95% CI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.015(1.911, 4.757)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.42(2.414, 11.076) *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnderweight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.503(0.325, 0.779)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.351(0.134, 0.919)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eExposed to PMTCT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.006(0.002, 0.013)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.648(0.132, 1.431)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSibling HIV status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e250\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.229(0.126, 0.415)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.749(1.09, 10.900) *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eParents HIV status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e257\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.01(0.005, 0.021)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.004(0.001, 0.012) *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWHO stage after follow-up\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage I\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage II and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.549(1.65, 3.937)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.183(1.815, 9.641) *\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eLevel of Adherence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e260\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.429(3.507, 11.737)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.467(1.601, 10.121)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eCD4 Count\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200\u0026ndash;350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;=350\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e255\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.552(0.255, 1.196)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.307(0.090, 1.044)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003cem\u003eAOR: Adjusted Odds Ratio; COR: Crude Odds Ratio; CI: Confidence Interval\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eEffectiveness of DTG Based Regimen Treatments\u003c/h2\u003e \u003cp\u003eThe study performed a bivariate analysis to identify variables with p-values lower than 0.25. This analysis highlighted several important factors, including ART treatment duration, history of TB treatment, history of opportunistic infection, sibling HIV status, parents HIV status, and adverse effect. These variables were then selected for further examination using multiple logistic regression.\u003c/p\u003e \u003cp\u003eThe results indicated that ART treatment duration, history of opportunistic infection, sibling HIV status, and adverse effects were significantly associated with the likelihood of the subjects having the effectiveness of ART treatment. Specifically, the findings revealed that the subjects that had more than 1 year ART treatment duration were 1.8 times more likely to effective from antiretroviral therapy (ART) compared to those who had less than 1 year of art treatment duration, with an adjusted odds ratio (AOR\u0026thinsp;=\u0026thinsp;1.831, 95% CI 1.105, 4.268). Additionally, participants who had HIV-positive siblings were found to be 2.3 times more likely to have effectiveness from ART than those without HIV-negative siblings (AOR\u0026thinsp;=\u0026thinsp;2.325, 95% CI: 1.044, 5.180). Conversely, participants who had a history of opportunistic infection were 31% less likely to effective ART treatment compared to those who did not have a history of opportunistic infection (AOR\u0026thinsp;=\u0026thinsp;0.69, 95% CI; 0.389, 0.978). Moreover, the study found that individuals who had drug adverse effects were 38.4% times less likely to effectiveness of ART treatment compared to had not have drug adverse effects (AOR\u0026thinsp;=\u0026thinsp;0.616, 95% CI: 0.288, 0.815) (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e The predictor of Effectiveness, of Dolutegravir-Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia 2025.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCategory\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eEffectiveness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eCOR 95% CI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAOR 95% CI\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePoor\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eART Treatment Duration\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;1 year\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.543(0.235, 1.252)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.831 (1.105, 4.268) *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;1years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e321\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHistory of TB Treatment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e311\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.629(0.215, 1.832)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.369(0.0821.655)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eHistory of opportunistic infection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e308\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.092(0.464, 2.573)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.69(0.389, 0.978) *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eSibling HIV status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNegative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e311\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePositive\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.046(0.975, 4.295)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2.325 (1.044, 5.180) *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eParents HIV status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNegative\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e246\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePositive\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e109\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.987(0.5160.998)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.68 (0243, 1.047)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAdverse effect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e235\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.777(0.403,0.899)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.616 (0.288, 0.815) *\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003cem\u003eAOR: Adjusted Odds Ratio; COR: Crude Odds Ratio; CI: Confidence Interval\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study is one of the few conducted in Africa that evaluates how well children and adolescents with HIV adhere to, benefit from, and safely use DTG-based Highly Active Antiretroviral Therapy (HAART) regimens. The use of Dolutegravir (DTG) at a daily dose of 50 mg is recommended for children who weigh 20 kg or more. As a result, the majority of participants in this study\u0026mdash;86%\u0026mdash;were adolescents, specifically those aged between 10 and 15 years.\u003c/p\u003e \u003cp\u003eThe study found that a significant portion of participants (11.9%) were known to be perinatally infected with HIV. This percentage is notably lower than previous studies, which reported that nearly 75% of HIV-infected children were perinatally infected (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Additionally, many of the patients in this study were experiencing advanced stages of HIV disease. This was indicated by the high percentage of participants classified at baseline with World Health Organization (WHO) stage 3 (65.9%) and a low number of CD4\u0026thinsp;+\u0026thinsp;cell counts, with only 2.2% having counts below 200 cells/mm\u0026sup3;.\u003c/p\u003e \u003cp\u003eMost of the patients enrolled in the study did not have siblings who were HIV positive. In this context, a \"sibling\" refers to a child who shares the same biological parents as the primary patient. While Prevention of Mother-to-Child Transmission (PMTCT) programs have shown success when properly implemented, there is a pressing need to enhance strategies that expand service coverage. This includes increasing early diagnosis of HIV in infants, both immediately after birth and during breastfeeding. To effectively reduce the risk of HIV infection within families, especially in areas where HIV is widespread, it is crucial to adopt a family-centered approach in HIV care programs. This approach should focus on the well-being of the entire family unit.\u003c/p\u003e \u003cp\u003eIn this study, one adherence assessment methods were used to allow triangulation to overcome the respective limitations of each data. In total, 90.1% of participants had good adherence in the treatment follow-up. A similar study conducted in Ethiopia was 90% (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). And the finding was greater than the study of conducted in Tanzania was 71%(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e), but the study was lower than the study conducted in Dar Es Salaam was 97% (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e), in western Kenya was 96.3% (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e), in rural Uganda (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e), and in Mbarara Regional Referral Hospital, 95.8% had a recorded good adherence in their files (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e), in Bergamo Italy Overall, adherence, as calculated from PDC, was very high with a median of 99% (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). Reasons for this were that patients must come to terms with their HIV status-associated stigma and try to fit the drug regimen into their daily schedules (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e). These factors are uncommon in children because they are not aware of their HIV status during diagnosis, as they were under the parent/guardian care, but as they age and become independent and aware of their HIV status, their level of adherence decreases due to the difficulty of coming to terms with the stigma associated with the condition.\u003c/p\u003e \u003cp\u003eAt the time of initiating treatment with dolutegravir (DTG), 65.9% of the participants were classified as having Clinical Stage III according to the World Health Organization (WHO) guidelines, but after follow-up, most of the participants had Clinical Stage I and II according to the World Health Organization (WHO) guidelines were 67.4% and 32.6% respectively. When we look at viral loads, 97.8% of participants had viral loads greater than 200 copies per milliliter at the start of their Antiretroviral Therapy (ART). In contrast, the current evaluation shows that only 87.4% of participants now have viral loads below this threshold, indicating an improvement in viral suppression. Regarding CD4 counts, 51.6% of participants had CD4 counts below 200 cells per cubic millimeter at the initiation of ART. Currently, this has significantly improved, with participants now having CD4 counts of 350 or higher. This suggests a positive response to the treatment over time.\u003c/p\u003e \u003cp\u003eOther study, in Spain was 83.4% of patients were virologically suppressed (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e), in sub-Saharan Africa was 67% of participants reported at least one (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e), in French was (82%) (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e), in Gondar Ethiopia was 91.7% (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e), in Paris, France was 91.7% (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e), in South-Western Uganda was the prevalence of virological suppression was 95.8% (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe proportion of patients who reported ADEs following the DTG-based regimen was 33.3%. this finding was greater than the study conducted in Tanzania were 16.5%(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e), in France, two patients (4%) experienced neurological side effects during follow-up (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e), in Paris, France was well tolerated; only one patient stopped treatment because of drug-related side effects (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e), in Portugal was 4.4%) reported side effects (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e), in California Dolutegravir was well tolerated, with all subjects experiencing at least one grade 1 or 2 transient clinical event (\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAdherence to antiretroviral therapy (ART) is essential for effectively managing HIV, particularly in children and adolescents. Various factors can significantly influence adherence, which can be categorized into two main groups: individual health and demographic factors, and psychosocial factors, based on recent studies. Children and adolescents with a low Body Mass Index (BMI) often face nutritional challenges that can hinder their overall health and ability to follow a treatment regimen. Being underweight may indicate insufficient nutritional support or underlying health problems, which can lead to fatigue and illness. This situation can create a cycle where poor adherence to ART worsens health issues. A history of tuberculosis (TB) treatment can also complicate the health of children and adolescents living with HIV. TB and HIV co-infection is common, and past TB treatments may result in lingering health effects, such as weakened immune function. These children might experience more frequent health problems, disrupting their ART adherence. Additionally, the psychological burden of having a serious illness like TB can further deter adherence to ongoing treatment. But Recent studies indicate that stigma (46.7%) is the leading reason for poor adherence in this population, followed by travel difficulties (33.3%) and alcohol use (20.0%). Factors such as age (children between 10 and 15 years), knowledge of HIV status, having a CD4 count of 500 or more, and the presence of comorbid illnesses are also significant predictors of poor adherence to the dolutegravir (DTG)-based ART regimen in children and adolescents.\u003c/p\u003e \u003cp\u003eThe use of Dolutegravir (DTG)-based antiretroviral therapy (ART) has become a standard approach for managing HIV in children and adolescents. However, several factors can lead to adverse drug reactions in this population. This discussion highlights key influences, such as the health status of siblings and parents, the clinical stage of the treatment, and the patient's sex. Children with HIV-negative siblings may experience emotional challenges that affect their treatment adherence and overall health, potentially increasing the risk of side effects. Similarly, when parents are HIV positive, children might face heightened anxiety about their own health and familial responsibilities, complicating their care and support systems. Moreover, those at the end of the follow-up, the Stage II or higher of the WHO classification, are more likely to experience adverse effects due to higher viral loads and greater immunosuppression, which can intensify the body's response to ART. Understanding these factors is crucial for optimizing treatment and support for young patients living with HIV.\u003c/p\u003e \u003cp\u003eThis study investigates the effectiveness of Dolutegravir (DTG)-based antiretroviral therapy (ART) in children and adolescents, revealing several key predictors that influence successful treatment outcomes. One significant factor is the duration of treatment: patients who remain on ART for over a year tend to experience better health and viral suppression, indicating that prolonged exposure stabilizes their condition. Additionally, Children and adolescents who have a history of opportunistic infections (OIs) do not show improvement when using DTG. This suggests that while DTG has strong antiviral effects, it may not be effective in preventing these infections from returning. Having an HIV-positive sibling also correlates with better outcomes, likely due to enhanced family support and increased awareness of HIV management.\u003c/p\u003e \u003cp\u003eBut the other study, treatment adherence is crucial, particularly for those aged 10\u0026ndash;14, who may face challenges in maintaining consistent medication routines. The study also highlights that remaining in care is essential for successful treatment, as regular medical oversight supports adherence. Malnutrition presents a significant barrier, as it can weaken the immune system, reducing the effectiveness of ART. Socioeconomic factors, such as living in coastal areas, may also affect access to healthcare and nutritional resources. Lastly, factors like the WHO clinical stage at diagnosis and multi-month prescriptions can enhance treatment effectiveness by promoting adherence and reducing the need for frequent healthcare visits.\u003c/p\u003e \u003cp\u003eThis study's primary drawback is its observational design, which makes it vulnerable to bias due to unmeasured confounders. However, this may have been lessened by the study participants' very high sample size. The presented results might have been improved by using two approaches to measure drug adherence, particularly the pharmacy-refill method.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study found that using dolutegravir (DTG)-based antiretroviral therapy (ART) in children and adolescents is safe, with only minor adverse drug events (ADEs) reported. Moreover, the DTG regimen has proven effective for this age group, including those who have previously undergone treatment and had high viral loads before switching to DTG therapy. Additionally, most children and adolescents demonstrated good adherence to the DTG treatment regimens.\u003c/p\u003e"},{"header":"List of Abbreviations","content":"\u003cp\u003eADE Adverse Effect\u003c/p\u003e\u003cp\u003eAIDS Acquired Immune Deficiency Syndrome\u003c/p\u003e\u003cp\u003eDCSTH Dessie Comprehensive Specialized Hospital\u003c/p\u003e\u003cp\u003eDTCSH Debre Tabor Comprehensive Specialized Hospital\u003c/p\u003e\u003cp\u003eDTG Dolutegravir\u003c/p\u003e\u003cp\u003eEFV Efavirenz\u003c/p\u003e\u003cp\u003eINSTI Integrase Strand Transfer Inhibitors\u003c/p\u003e\u003cp\u003eHIV Human Immunodeficiency Virus\u003c/p\u003e\u003cp\u003eFHCSH Felege Hiwot Comprehensive Specialized Hospital\u003c/p\u003e\u003cp\u003eWCSH Woldia Comprehensive Specialized Hospital\u003c/p\u003e\u003cp\u003eWHO World Health Organization\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approved by the Institutional Review Board (IRB) of the College of Health Sciences, Woldia University with reference number 629/25, and Ethiopian Public Health Institute Amhara region branch (APHI) with reference number -APHI/M/l/D/-T-03/807-03/807 to conduct the study. \u0026nbsp;Ethics approval and consent to participate in this study were confirmed by the IRB of College of Health Sciences, Woldia University, and APHI confirming that all the methods were performed according to the rules and regulations of the IRB, Hospitals, and by the 1964 Helsinki Declaration. Informed consent was impracticable to this study. This study was done by the Helsinki Declaration which stated that “medical research using identifiable human material or data, physicians must normally seek consent for collection, analysis, and storage and/or reuse. There may be conditions where obtaining informed consent from the participants would be impossible or impracticable and threaten the validity of the research. In this instance, the research may be done after considerations and approval of the IRB”. The ethical approvals were submitted to study area hospitals. Letters of permission were also obtained from the hospitals. Finally, permission letters were submitted to the hospitals’ ART Clinic card rooms. Thus, the informed consent of the participants was waived by the IRB of the College of Health Sciences, Woldia University and APHI. The collected data were kept anonymous and confidentiality was maintained.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no any competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFinancial support for data collection was obtained from University of Woldia. The funding institution has no any role in the designing and acquisition of this study and preparation of the manuscript as well as the decision to publish.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated during the current study are not publicly available due to confidentiality issues since the study was conducted among children and adolescent. But data will be available upon reasonable request from the corresponding author.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDT worked on developing the research idea, designing the study, being involved in proposal writing, training and supervising the data collectors, analyzing and interpreting the results, and preparing the manuscript. YAD, TM, FDB and ADG played their role in critically revising the proposal, participating in its design, analyzing and interpreting the results, and writing the manuscript. All authors were involved in reading and approving the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;First, we would like to thank Woldia University College of health sciences, department of pediatrics and child health nursing for giving a chance to conduct this research. Also, we would like to thank Amhara Regional State public hospital staffs and data collectors for giving necessary information. Our special thanks go to for data collectors without whom it may not possible to accomplish this study. Finally, we would like to thank supervisors their unreserved encouragement, and guidance in the overall process of the data collection.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eOrganization WH. Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV: interim guidelines: supplement to the 2016 consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. World Health Organization; 2018.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUmar D, Waziri B, Ndagi U, Mohammed S, Usman N, Abubakar-Muhammad H. 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Antiretroviral treatment of adult HIV infection: 2014 recommendations of the International Antiviral Society\u0026ndash;USA Panel. JAMA. 2014;312(4):410\u0026ndash;25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eManosuthi W, Ongwandee S, Bhakeecheep S, Leechawengwongs M, Ruxrungtham K, Phanuphak P, et al. Guidelines for antiretroviral therapy in HIV-1 infected adults and adolescents 2014. Thail AIDS Res therapy. 2015;12:1\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDesai M, Iyer G, Dikshit R. Antiretroviral drugs: critical issues and recent advances. Indian J Pharmacol. 2012;44(3):288\u0026ndash;98.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGupta RK, Gregson J, Parkin N, Haile-Selassie H, Tanuri A, Forero LA, et al. HIV-1 drug resistance before initiation or re-initiation of first-line antiretroviral therapy in low-income and middle-income countries: a systematic review and meta-regression analysis. Lancet Infect Dis. 2018;18(3):346\u0026ndash;55.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFood E. Adverse drug events reported on DTG-containing regimens: Preliminary analysis report. 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMutagonda RF, Mlyuka HJ, Maganda BA, Kamuhabwa AA. Adherence, effectiveness and safety of dolutegravir based antiretroviral regimens among HIV infected children and adolescents in Tanzania. J Int Association Providers AIDS Care (JIAPAC). 2022;21:23259582221109613.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMaghembe AA, de Boer MS, Marikias G, Amour C, Mahande MJ, HIV VIRAL SUPPRESSION, AND ASSOCIATED FACTORS AMONG CHILDREN AND ADOLESCENTS ON A DOLUTEGRAVIR (DTG.) BASED ANTIRETROVIRAL REGIMEN IN TANZANIA MAINLAND. medRxiv. 2023:2023.05. 17.23290106.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBruzzese E, Lo Vecchio A, Smarrazzo A, Tambaro O, Palmiero G, Bonadies G, et al. Dolutegravir-based anti-retroviral therapy is effective and safe in HIV\u0026ndash;infected paediatric patients. Ital J Pediatr. 2018;44:1\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFrange P, Avettand-Fenoel V, Veber F, Blanche S. Similar efficacy and safety of dolutegravir between age groups of HIV‐1‐infected paediatric and young adult patients aged 5 years and older. HIV Med. 2019;20(8):561\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCurtis L, Nichols G, Stainsby C, Lim J, Aylott A, Wynne B, et al. Dolutegravir: clinical and laboratory safety in integrase inhibitor\u0026ndash;naive patients. HIV Clin Trial. 2014;15(5):199\u0026ndash;208.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePatel DA, Snedecor SJ, Tang WY, Sudharshan L, Lim JW, Cuffe R, et al. 48-week efficacy and safety of dolutegravir relative to commonly used third agents in treatment-naive HIV-1\u0026ndash;infected patients: a systematic review and network meta-analysis. PLoS ONE. 2014;9(9):e105653.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCahn P, Pozniak AL, Mingrone H, Shuldyakov A, Brites C, Andrade-Villanueva JF, et al. Dolutegravir versus raltegravir in antiretroviral-experienced, integrase-inhibitor-naive adults with HIV: week 48 results from the randomised, double-blind, non-inferiority SAILING study. Lancet. 2013;382(9893):700\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eComi L, Maggiolo F. Abacavir+ dolutegravir+ lamivudine for the treatment of HIV. Expert Opin Pharmacother. 2016;17(15):2097\u0026ndash;106.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRaffi F, Jaeger H, Quiros-Roldan E, Albrecht H, Belonosova E, Gatell JM, et al. Once-daily dolutegravir versus twice-daily raltegravir in antiretroviral-naive adults with HIV-1 infection (SPRING-2 study): 96 week results from a randomised, double-blind, non-inferiority trial. Lancet Infect Dis. 2013;13(11):927\u0026ndash;35.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRaffi F, Rachlis A, Stellbrink H-J, Hardy WD, Torti C, Orkin C, et al. Once-daily dolutegravir versus raltegravir in antiretroviral-naive adults with HIV-1 infection: 48 week results from the randomised, double-blind, non-inferiority SPRING-2 study. Lancet. 2013;381(9868):735\u0026ndash;43.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEron JJ, Clotet B, Durant J, Katlama C, Kumar P, Lazzarin A, et al. Safety and efficacy of dolutegravir in treatment-experienced subjects with raltegravir-resistant HIV type 1 infection: 24-week results of the VIKING Study. J Infect Dis. 2013;207(5):740\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCastagna A, Maggiolo F, Penco G, Wright D, Mills A, Grossberg R, et al. Dolutegravir in antiretroviral-experienced patients with raltegravir-and/or elvitegravir-resistant HIV-1: 24-week results of the phase III VIKING-3 study. J Infect Dis. 2014;210(3):354\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTassew SG, Abraha HN, Gidey K, Gebre AK. Assessment of drug use pattern using WHO core drug use indicators in selected general hospitals: a cross-sectional study in Tigray region, Ethiopia. BMJ open. 2021;11(10):e045805.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAynalem GA, Bekele TA, Alemayehu FA. Drug use evaluation of vancomycin at medical ward of Yekatit 12, hospital medical college, Addis Ababa, Ethiopia, 2018. Int J Sci Rep. 2020;6(10):381.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZeleke SA, Tebabal AT, Kebede A, Yayehrad AT, Abie DD, Siraj EA, et al. Adherence to Dolutegravir-Based Antiretroviral Therapy and Its Associated Factors Among Children Living With HIV in Bahir Dar City Administration Public Health Institutions. North West Ethiopia. 2025;12:30502225251314349.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMghamba FW, Minzi OM, Massawe A, Sasi PJB. Adherence to antiretroviral therapy among HIV infected children measured by caretaker report, medication return, and drug level in Dar Es Salaam. Tanzania. 2013;13:1\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVreeman RC, Nyandiko WM, Liu H, Tu W, Scanlon ML, Slaven JE, et al. Measuring adherence antiretroviral therapy Child adolescents western Kenya. 2014;17(1):19227.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWahome E, Fegan G, Okuku HS, Mugo P, Price MA, Mwashigadi G et al. Evaluation of an empiric risk screening score to identify acute and early HIV-1 infection among MSM in Coastal Kenya. 2013;27(13):2163\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKabiibi F, Tamukong R, Muyindike W, Yadesa TMJHA-R, Care P. Virological Non-Suppression, Non-Adherence and the Associated Factors Among People Living with HIV on Dolutegravir-Based Regimens: A Retrospective Cohort Study. 2024:95\u0026ndash;107.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMaggiolo F, Valenti D, Teocchi R, Comi L, Filippo ED. Rizzi MJJotIAoPoAC. Adherence to and forgiveness of 3TC/DTG in a real-world cohort. 2022;21:23259582221101815.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGare J, Ryan CE, David M, Timbi D, Kaima P, Kombati Z, et al. Presence of HIV drug resistance in antiretroviral therapy-naive and-experienced patients from Papua. New Guin. 2014;69(8):2183\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRodriguez-Gonzalez CG, Chamorro-de-Vega E, Ortega-Navarro C, Alonso R, Herranz-Alonso A, Sanjurjo-Saez MJAP. Effectiveness, safety, and costs of dolutegravir/abacavir/lamivudine single-tablet regimen in a real-life cohort of HIV-1 adult infected patients. 2020;54(7):633\u0026ndash;43.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMcCluskey SM, Pepperrell T, Hill A, Venter WD, Gupta RK, Siedner MJJA. Adherence, resistance, and viral suppression on dolutegravir in sub-Saharan Africa: implications for the TLD era. 2021;35(Supplement 2):S127\u0026ndash;35.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBriand C, Dollfus C, Faye A, Kantor E, Avettand-Fenoel V, Caseris M et al. Efficacy and tolerance of dolutegravir-based combined ART in perinatally HIV-1-infected adolescents: a French multicentre retrospective study. 2017;72(3):837\u0026ndash;43.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGebremedhin T, Ayenalem M, Adem M, Geremew D, Aleka Y, Kiflie A. Dolutegravir based therapy showed CD4\u0026thinsp;+\u0026thinsp;T cell count recovery and viral load suppression among ART na\u0026iuml;ve HIV positive individuals: A longitudinal evaluation. 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFrange P, Avettand-Fenoel V, Veber F, Blanche SJH. Similar efficacy and safety of dolutegravir between age groups of HIV‐1‐infected paediatric and young adult patients aged 5 years and older. 2019;20(8):561\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFurtado I, Valdoleiros S, Fragoso J, Vasconcelos O, Gon\u0026ccedil;alves M, Sarmento-Castro RJH et al. Clinical experience with dolutegravir: efficacy, safety, and tolerability. 2022;21(1):10\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eViani RM, Alvero C, Fenton T, Acosta EP, Hazra R, Townley E et al. Safety, pharmacokinetics and efficacy of dolutegravir in treatment-experienced HIV-1 infected adolescents: forty-eight-week results from IMPAACT P1093. 2015;34(11):1207\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"adherence, effectiveness, safety, children, adolescents, antiretroviral therapy, dolutegravir","lastPublishedDoi":"10.21203/rs.3.rs-8707598/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8707598/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003e \u003cb\u003e-\u003c/b\u003e The World Health Organization recommends integrase inhibitor dolutegravir as the first- and second-line treatment of choice for Human Immunodeficiency Virus in July 2019 for all populations. Since 2019, Ethiopia's Ministry of Health has advised adults, adolescents, and expectant mothers to use it as their initial antiretroviral treatment regimen. There are limited studies demonstrating the adherence, effectiveness, and safety of children and adolescent dolutegravir regimen therapy in Ethiopia.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003e \u003cb\u003e-\u003c/b\u003e institutional based retrospective follow up study conducted by involving children and adolescent with dolutegravir regimen therapy at antiretroviral therapy clinic of Amhara Region Specialized Hospitals. Eligible children and adolescents were consecutively recruited at admission and followed up for one (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) year. The sample size of ART children and adolescents was 403 included in the study. A simple random sampling technique by lottery methods was used. Data were collecting using structured questionnaire from client medical record folder. The data was analysis by using SPSS Version 25 software and evaluate the data with Binary logistic regression Model. Descriptive statistics were computed depending on the nature of the variables. Binary logistic regression Model used to assess predictors. Predictors considered statistically significant if P -value was less than 0.05.\u003c/p\u003e\u003ch2\u003eResult\u003c/h2\u003e \u003cp\u003e \u003cb\u003e-\u003c/b\u003e In total, 90.1% of participants adhered well to the treatment. At the start, 65.9% of those on DTG were in WHO Clinical Stage III. After follow-up, 67.4% were in Stage I and 32.6% in Stage II. Initially, 97.8% had viral loads above 200 copies/mL, but after one year on DTG, 87.4% were dropped below the threshold. CD4 counts improved significantly: 51.6% began below 200 cells/mm\u0026sup3;, but with most now at 350 or higher. Additionally, 33.3% of patients reported adverse drug effects (ADEs) following the DTG regimen.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003e \u003cb\u003e-\u003c/b\u003e This study indicated that the use of DTG-based ART in children and adolescents is safe with minor ADEs. In addition, the DTG regimen is successful in this population, especially in treatment-experienced children who had high viral load before converting to DTG-based therapy. However, the majority of kids and teenagers adhered well to DTG regimens.\u003c/p\u003e","manuscriptTitle":"Adherence, Effectiveness, Safety and Predictors of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Amhara Regional Specialized Hospitals, Ethiopia: Retrospective Follow up Study.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-09 12:34:02","doi":"10.21203/rs.3.rs-8707598/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7f1764a8-5715-4396-8af6-3f287aebc976","owner":[],"postedDate":"February 9th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-07T10:47:11+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-09 12:34:02","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8707598","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8707598","identity":"rs-8707598","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}